Provider Demographics
NPI:1528607975
Name:RAFFERTY, HAYLEY (APRN)
Entity type:Individual
Prefix:
First Name:HAYLEY
Middle Name:
Last Name:RAFFERTY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:HALEY
Other - Middle Name:ALEXANDRIA
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1401 3RD AVE N APT 531
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37208-3288
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4928 EDMONDSON PIKE STE 205
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-4791
Practice Address - Country:US
Practice Address - Phone:156-222-1400
Practice Address - Fax:615-222-1410
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-02
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN26570363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health